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Risk approaches and standards used in hospitals: a survey of industry views

RISK APPROACHES AND STANDARDS USED IN HOSPITALS:
A SURVEY OF INDUSTRY VIEWS
By
Haven McCall
A Dissertation Presented to the
FACULTY OF THE USC SCHOOL OF PHARMACY
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF REGULATORY SCIENCE
December 2013
Copyright 2013 Haven McCall

Risk management is an important tool to decrease medical errors and to improve overall quality of care in US hospitals. To gain insight into current practices in US hospitals, survey methods were used to explore the extent to which risk management systems in hospitals have the tools, resources and staffing appropriate to handle and improve risk management. A survey instrument was developed by reference to a research framework based on the "conceptual" model of Sullivan and Beach as modified by Chan that emphasizes the importance of a triad of elements, including resources, competence and memory. The purpose of the survey was to determine current approaches and hiring practices in risk management within the hospital industry. It further probed the focus of risk management activities performed by risk managers, their views of risk management standards and approaches being used in hospitals and the use of methodologies. It was clear from both a voluminous literature on this topic and the survey that hospitals still have many challenges with regard to implementing risk management systems and processes. Most hospitals had only one or a few risk management personnel who had little ongoing training and background preparation in risk management methodology. They performed a large variety of tasks and were faced with a large range of risks. Nevertheless, they typically expressed satisfaction with their work, with mixed views on the level of support that they received from senior management. Typically missing from the system was a systematic set of standards for identifying, prioritizing and controlling areas of greatest risk based on their performance metrics. Although the framework used for this study was primarily oriented to assessing performance, results suggested that hospital culture and behaviors often seemed to contribute to key concerns, such as the willingness to hire individuals with little background in formal risk management and to accept as standard practice the use of only very risk management tools.

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RISK APPROACHES AND STANDARDS USED IN HOSPITALS:
A SURVEY OF INDUSTRY VIEWS
By
Haven McCall
A Dissertation Presented to the
FACULTY OF THE USC SCHOOL OF PHARMACY
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF REGULATORY SCIENCE
December 2013
Copyright 2013 Haven McCall